Medicare officials continue to work toward improved transparency in provider outcomes

Medicare officials are making progress in their efforts to help patients “shop” for doctors, including pathologists. It has gone live with a new website called “Physician Compare.” This website offers many search functions not previously available.

The Centers for Medicare and Medicaid Services (CMS) put up the new website to fulfill one mandate of the healthcare reform law, known as the Patient Protection and Affordable Care Act (PPACA) of 2010. CMS expanded the information available to healthcare consumers on its online physician directory tool.

Although pathologists are included in the CMS Physician Compare website, the Medicare program has yet to develop listings of clinical laboratories that patients can use to identify possible sources of medical laboratory testing in their communities. This type of information is planned for future enhancements to the CMS website.

Medicare beneficiaries can still shop for physicians in their area by specialty and by Zip code (expandable by miles). What is new is that patients can now determine whether the healthcare provider accepts the Medicare-approved amount as “full payment” for all services. This important feature was not fully implemented in the previous version of the site. It is expected to be quite popular with beneficiaries.

This latest round of website improvements demonstrates that CMS continues to push for more transparency in healthcare.

This latest round of website improvements demonstrates that CMS continues to push for more transparency in healthcare.

Streamlining Access to Information about Physicians

The Physician Compare interface is a great improvement as well. It’s simpler and easier to navigate than the previous interface. The Medicare website includes more information on the Medicare physicians and practices. For example, patients now can select whether to include all male physicians, all female, or both. Medicare beneficiaries can also search for specific physicians based on full or partial last names, as well as within specific specialties and silos. For example, a partial list of searchable specialties includes:

• Anesthesiology
• Cardiology
• Critical Care
• Dermatology
• Emergency Medicine
• Gastroenterology
• Internal Medicine
• Neurology
• Obstetrics and Gynecology
• Oncology
• Pain Management
• Pathology
• Radiology
• Urology

The site also now includes non-physician positions, searchable by type. They include:

• Anesthesiologist Assistant
• Audiology
• Nurse—Anesthetist
• Nurse—Clinical Specialist
• Nurse—Midwife
• Nurse—Practitioner
• Nutrition Services
• Physician Assistant
• Psychology—Clinical
• Psychology—Independent
• Social Work
• Therapy—Occupational
• Therapy—Physical

In 2011, CMS also plans to enable users to search for physicians who prescribe medications electronically (e-prescribing). This is an effort to promote adoption of e-prescribing among Medicare physicians.

Comparing the Quality of Healthcare

As welcomed as these improvements might be, what’s conspicuous by its absence is any ability to compare physicians by the quality of their care. The inability for healthcare consumers to shop for quality healthcare in a transparent industry was touted as a primary reason for sky rocketing healthcare costs. President Obama promised that his massive healthcare reform bill would correct this issue. However, CMS has yet to include quality comparisons on its website, making its name—Physician Compare—a bit of a misnomer.

Other sectors of healthcare are actually ahead of CMS on improved transparency of provider outcomes, and have been so for quite some time. On The Leapfrog Group’s website, consumers can search for healthcare providers in their area by city and state, Zip code and hospital name as well. Consumers can, however, also compare hospitals based on overall safety ratings, and by safety ratings based on specific procedures. This is an important distinction.

While it’s good to know in advance whether a provider accepts the Medicare-approved amount as full payment, it’s also good to know if a specific physician has a significantly higher safety rating on, say, heart bypass surgery, than another physician. Patients want that information too, but so far, CMS hasn’t added it. Nevertheless, CMS is making progress in the right direction, and announced that it will be adding quality comparisons to future versions of the site.

This latest round of website improvements demonstrates that CMS continues to push for more transparency in healthcare. That is one reason why pathology is included among the specialties now searchable on Physician Compare. Clinical laboratories can expect that, in the future, it will not be just patients who search for quality providers. Physicians themselves will also want to use these outcomes comparison websites when selecting which medical laboratories to involve in the care of their patients.

—Michael McBride

Related Information:

Physician Compare

CMS Launches First Phase of Physician Compare Site

CMS Updates “Physician Compare” Online Tool